Objective To reveal the present situation of geriatric nursing, summarize the important research topics, in order to determine the focus of the research and work of geriatric nursing in China. Methods To take geriatric nursing belonged to MeSH thesaurus as key words, related literatures from 2006 to 2016 in Web of Science core collection were searched, then clustering analysis were adopted to analyze highly cited papers. Results Totally 2148 pieces of literatures related to geriatric nursing, there were 80079 pieces of quotations. The contents involved inappropriate medication use and falls in geriatric nursing risk management, functional decline, delirium and chronic cognitive impairment of the elderly, distinguishing between the basic theory of geriatric diseases, tools and practice of geriatric nursing assessment. Conclusions The current research hotspots on geriatric nursing includes: the risk management of geriatric nursing, prevention and control of geriatric syndrome, systematic study on geriatric nursing assessment.

[Abstract ] Objective Cofilin-1 is involved in the pathogenesis of various tumours .However, the expression and effect of Cofilin-1 in hepatocellular carcinoma is not clear .The aim of this study is to observe the Cofilin-1 gene expression in human hepatocel-lular carcinoma (HCC) tissues, and to explore the effect of Cofilin-1 gene expression on invasion and metastasis of HCC HuH-7 cells. Methods Real-time quantitative PCR was used to assess the Cofilin-1 gene expression in human HCC tissues and normal tumor-ad-jacent tissues.The specific small interfering RNA ( siRNA) of Cofilin-1 sequence was synthetized in vitro , and was transfected into HCC HuH-7 cells using liposome transfection.The experiment was divided into Cofilin-1-siRNA group, Ctrl-siRNA group and un-transfected group.Western blot assay was used to detect the protein expression of Cofilin-1.Migration and invasion experiments in vitro were used to investigate the invasive ability of transfected cells. Results Compared with the adjacent liver tissue , Cofilin-1 gene ex-pression in human liver cancer tissue was significantly increased (0.698 ±0.156 vs 3.523 ±0.412, P<0.05).The expression of Cofilin-1 protein in Cofilin-1-siRNA group was 0.558 ±0.033, which was lower than that in Ctrl-siRNA group ( 0.933 ±0.015 )
and in untransfected group (0.961 ±0.020) (P<0.05).The results of migration and invasion experiments in vitro showed that the amount of migration and invasion cells in Cofilin-1-siRNA group were significantly lower than Ctrl-siRNA group or untransfected group (58.50 ±1.78 vs 79.00 ±1.33, 74.50 ±1.35,P<0.05; 36.50 ±0.83 vs 60.20 ±1.60, 51.50 ±1.14, P<0.05). Conclusion Cofilin-1 is highly expressed in HCC, and the invasion and metastasis of HCC HuH-7 cells is suppressed by inhibiting the Cofilin-1 gene expression.

Purpose To investigate the second generation dual source CT low tube voltage (100 kV) combined with sonogram-affirmed iterative reconstruction (SAFIRE) in assessing coronary artery stents. Materials and Methods One hundred and fifty-six patients underwent CT coronary angiography after implanted coronary artery stents. Among all the patients, 86 cases were performed with 100 kV combined with SAFIRE, and 70 cases with 120 kV combined with filtered back projection reconstruction (FBP). Mean CT values, image noise, SNR, SAIR, image quality scores, stents detecting and radiation dose of aortic root, inner-stent, and the coronary artery proximal to the stent were compared. Results The mean CT value of aortic root, inner-stent, and the coronary artery proximal to the stent of 100 kV group was higher than that of 120 kV group (t=2.75, 11.77 and 3.19, P<0.05), while image noise and SAIR of 100 kV group were lower than those of 120 kV group (t=-2.53 and -9.51, P<0.05). SNR of aortic root, inner-stent, and the coronary artery proximal to the stent was not statistically different between the two groups (t= -1.34, -0.95 and 1.67, P>0.05). There was no statistic difference of image quality score between the two groups (t= -0.203, P>0.05). Totally there were 243 stents detected, including 67 of right coronary artery, 123 of left anterior descending, 36 of left circumflex, and 17 of other branches. Stent length ranged 3.8 to 98.7 mm and averaged (27.5±16.4) mm. The CTDIvol, DLP and ED of 100 kV group were lower than those of 120 kV group (t= -11.03, -9.41 and -9.41, P<0.05). The effective dosage reduced about 51.5% in 100 kV group when compared with that of 120 kV group. Conclusion The second generation dual source CT low tube voltage (100 kV) combined with SAFIRE in assessing coronary artery stent could meet the diagnostic requirement and reduce the radiation dosage, without increasing image noise and beam hardening artifacts.

Background and purpose:The molecular mechanism of the pathogenesis of poorly differentiated gastric carcinoma is unclear, because the key genes related to poorly differentiated gastric carcinoma have not been identified. The study was designed to establish the gene expression profile of poorly differentiated gastric carcinoma, isolate gastric carcinoma-related genes, and investigate the relationship between gastric carcinoma-related genes and gastric carcinoma. Methods:The changes of gene expression profile between poorly differentiated gastric carcinoma and adjacent normal tissue of gastric epithelia were analyzed by cDNA microarray which represented approximately 10 000 known genes that would be tested in the assay. Immunohistochemistry were employed to validate the relationship between gastric carcinoma-related genes and gastric carcinoma.Results:212 genes that were differentially expressed in cancer and non cancerous tissues were identified; 169 genes were highly expressed in cancer tissues by more than 2.0 fold, 43 genes were lower expressed in cancer tissues by more than 2.0 fold. EMS1 protein was located in cytoplasma. The positive rate of EMS1 protein expression was 20% (4/20) in normal gastric mucosa and 89.72% (131/146) in the gastric carcinoma, the difference was significant (P

Objective To explore the feasibility of DSCT dual-energy technique in pulmonary mass lesions.Methods A total of 100 patients with pulmonary masses underwent conventional plain CT scan and dual-energy enhanced CT scan.The virtual non-contrast (VNC) images were obtained at post-processing workstation.The mean CT value,enhancement value,signal to noise ratio (SNR),image quality and radiation dose of pulmonary masses were compared between the two scan techniques using F or t test and the detectability of lesions was compared using Wilcoxon test. Results There was no statistically significant difference among VNC ( A ) ( 32.89 ± 12.58 ) HU,VNC (S) ( 30.86 ± 9.60) HU and conventional plain images (35.89 ± 9.99 ) HU in mean CT value of mass ( F =2.08,P ＞ 0.05 ).There was statistically significant difference among VNC ( A ) ( 3.29 ± 1.45 ),VNC (S) ( 3.93 ± 1.49 ) and conventional plain image (4.61 ± 1.50) in SNR ( F =6.01,P ＜ 0.05 ),which of conventional plain scan was higher than that of VNC.The enhancement value of mass in conventional enhanced scan(60.74 ± 13.9)HU and distribution of iodine from VNC (A) ( 58.26 ± 31.99 ) HU was no statistically significant difference ( t =0.48,P ＞ 0.05 ),but there was a significant difference between conventional enhanced scan (56.51 ± 17.94 ) HU and distribution of iodine from VNC (S) (52.65 ± 16.78 ) HU (t =4.45,P ＜ 0.05 ).There was no statistically significant difference among conventional plain scan ( 4.69 ± 0.06 ) and VN C ( A ) ( 4.60 ± 0.09 ),VNC (S)(4.61 ±0.11 ) in image quality at mediastinal window ( F =3.014,P ＞ 0.05 ).The appearance,size,internal features of mass (such as necrosis,calcification and cavity) were showed the same in conventional plain scan,VNC (A) and VNC (S).Of 41 patients with hilar mass,18 patients were found to have lobular and segmental perfusion decrease or defect. Perfusion defect area was found in 59 patients with peripheral lung mass. The radiation dose of dual-energy enhanced scan was lower than that of conventional scan.Conclusion The virtual non-contrast,distribution of iodine and pulmonary virtual perfusion images can be obtained by DSCT dual-energy technique in one scan,which has a potential clinical value in the thorax.

BACKGROUND: Differentiation of neural stem calls (NSCs) was mediated by many environmental factors. Several factors can induce NSCs to differentiate into neurons in varying degrees and it is now a focus on the control of NSCs differentiation.OBJECTIVE: To study the effects of combination of basic fibroblast growth factor (bFGF) and brain-derived neurotrophic growth factor (BDNF) on the differentiation of NSCs into neurons.DESIGN, TIME AND SETTING: The in vitro cytology observation was performed at the Neurotomia Laboratory of China Medical University in May 2008.MATERIALS: Three adult male SD rats were provided by Experimental Animal Center of China Medical University.METHODS: Dispositions to the rats were consistent with ethical standards of animals. The rat brain hippocampus was removed sterilely. After trypsin digestion, NSCs were cultured in serum-free medium. Cell suspension was prepared and diluted when the diameter of the fourth passage of clone sphere was 200 μm by mixture of DMEM/F12 containing 2% B27, 20 μg/L of epidermal growth factor (EGF), and 20 μg/L bFGF. Monoclonal calls were passagad. NSCs were divided into blank control, bFGF, BDNF and bFGF+BDNF groups by different growth factors added into the media. Fetal bovine serum of 0.1 volume fraction was added in blank control group. The media in the other three groups were added bFGF, BDNF and bFGF+BDNF respectively for 1 week.The concentration of bFGF was 10 μg/L and the concentration of BDNF was 200 μg/L.MAIN OUTCOME MEASURES: Immunocytochemistry staining was used to identify NSCs as well as to detect the differentiation of NSCs into neurons.RESULTS: The monoclonal calls expressed nestin and the differentiated call expressed neuron specific enolase and glial fibrillary acidic protein. Compared to blank control group, the proportion NSCs into neurons in the bFGF group, BDNF group and bFGF+BDNF group were much higher (t=3.409-7.558, P < 0.05), with the highest in bFGF+BDNF group (t =7.558, P < 0.05).CONCLUSION: Combination of bFGF and BDNF can promote the differentiation of adult hippocampus NSCs into neurons.

BACKGROUND:It is confirmed that astrocytes can differentiate into neurons by Neurogenin2 gene regulation, suggesting that Schwann cells may also differentiate into neurons by gene regulation.
OBJECTIVE:To evaluate the feasibility of Schwann cells differentiating into neurons by Neurogenin2 gene regulation.
METHODS:Rats Schwann cells were isolated, purified and identified. Then the Schwann cells were transfected with Neurogenin2 via green fluorescent protein gene-plentivirus. To induce neuronal differentiation, the Schwann cells were cultured in serum-free Dulbecco’s modified Eagle’s medium containing epidermal growth factor, basic fibroblast growth factor and brain-derived neurotrophic factor for 2 weeks. The morphology of induced cells was observed by microscope, and myelin basic protein and neuron-specific enolase were detected by immunocytochemistry.
RESULTS AND CONCLUSION:After transfection with Neurogenin2 via green fluorescent protein gene-plentivirus and induced differentiation, immunofluorescence assay demonstrated that 12.56%of the induced cellexpressed neuron-specific enolase, but the control group did not express neuron-specific enolase. Neurogenin2 gene-transfected Schwann cells can express neuron-specific enolase, suggesting Neurogenin2 gene may regulate transdifferentiation of Schwann cells into neurons.

Objective To explore the value of intelligent optimum tube voltage technology at dual-source CT coronary angiography.Methods One hundred and fifty patients with normal body mass index (＜25 kg/m2) with clinically suspected coronary heart disease requiring coronary artery CTA examination were collected.According to the different scanning method,patients were randomly divided into 5 groups,30 cases of each group were tested by coronary artery CTA examination.The intelligent optimum tube vohage scanning technology was set to Semi,the tube voltage of A,B,C group were 120,100 and 80 kV (Ref 120 kV,400 mAs),respectively.D and E group were set to on,the reference voltage of group D was 120 kV,and reference current was 400 mAs.The reference voltage of group E was 100 kV,reference current was 400 mAs.Using the 15 section improved segment method for evaluation of coronary artery (lumen diameter＞ 2 mm and no severe calcification).They were assessed by subjective evaluation (image quality score) and objective evaluation (including vascular CT value,signal-to-noise ratio and contrast to noise ratio).Analyses of the differences between groups were compared with image quality,objective evaluation index and radiation dose by single factor variance.Results The image quality scores in patients scanned with five groups were (3.42±0.63),(3.41±0.54),(3.49±0.33),(3.45±0.43) and (3.48±0.81),there was no statistical difference between the five groups (F=0.634,P=0.105).Each image quality was good,all could clearly show thewhole range of vessels.The CT values of the coronary artery with above groups respectively were (486±82),(554±71),(742±90),(506±81),(561±81) HU.The image noises were (25±12),(32±12),(46±14),(28± 11),(34±12) HU (F=3.430 and 4.332,P＜0.05).And the SNR and CNR was no statistic difference between the five groups (P＞0.05).The effective radiation dose of five groups are (9.3± 1.3),(6.3± 1.4),(2.8±1.5),(5.7 ± 1.2),(3.9 ± 1.3) mSv,which the difference was statistically significant (F=2.332,P＜0.05).Conclusions Intelligent optimum tube voltage technology (Ref.100 kV,400 mAs) at dual-source CT coronary angiography may be feasible in patients with normal BMI.To ensure the quality of the image at the same time,it can effectively reduce the radiation dose.

Purpose To explore CT manifestations of thyroid carcinoma and its correlation with neck lymph node metastasis. Materials and Methods CT findings of 165 patients with thyroid carcinoma confirmed by surgical pathology were studied, including number, shape, size, calcium, necrosis, surrounding invasion and enhancement of substantial part, and its correlation with neck lymph node metastasis was also analyzed. Results 107 out of 165 patients (64.85%) suffered from neck lymph node metastasis. Different tumor number, calcium and necrosis were not associated with the rate of neck lymph node metastasis (χ2=0.009, 2.606, 1.522;P>0.05);tumor shape, size, surrounding invasion and enhancement were significantly different from the rate (χ2=26.510, 75.995, 68.922, 20.819;P<0.05). Patients age, tumor shape, size, enhancement and surrounding invasion were positively correlated with lymph node metastasis (r=0.124, 0.243, 0.276, 0.287, 0.395;P<0.05);the sequence of correlation was as follows:surrounding invasion>enh ancement>shape>size>age. However, patients gender, tumor number, calcium and necrosis showed on correlation (r=0.074, 0.126, 0.005, 0.121;P>0.05). Conclusion Lymph node metastasis is mainly associated with factors like age, tumor shape, size, enhancement and surrounding invasion. It is advisable that patients with high risk rate may consider selective cervical lymph node dissection.

Objective To investigate the expression of heat shock protein 27(HSP27)in esophageal squamous carcinoma,mucosa adjacent to carcinoma and normal esophageal mucosa,and its relationship with the carcinogenesis of esophageal carcinoma.Methods The expression of HSP27 was observed in 86 specimens from esophageal squamous carcinoma,86 from mucosa adjacent to carcinoma and 75 from normal esophageal mucosa by immunohistochemistry.Results The expression of HSP27 in esophageal squamous carcinomas was higher than those in mucosa adjacent to carcinoma(P ＜ 0.05);the expression of HSP27 in mucosa adjacent to carcinoma was higher than those in normal esophageal mucosa(P ＜0.001).There was no significant difference in the expression of HSP27 in esophageal squamous carcinomas with different differentiation degree(P ＞ 0.05).Conclusion Expression of HSP27 was associated with the carcinogenesis of esophageal squamous carcinoma.